Análise biomecânica da influência do comprimento e angulação em implantes distais de reabilitações all-on-four em maxilas: um estudo de análise de elementos finitos

Abstract

The objective of this dissertation was to evaluate the biomechanical influence of different lengths and angulations of distal implants in All-on-Four maxillary rehabilitations. The biomechanical impact of variations in distal implant angulation, implant length, implant design, applied force on the models, and clinical conditions simulating immediate and delayed loading was assessed, totaling 64 simulated finite element models. The analysis included peak equivalent strain, the volume of bone subjected to microstrains exceeding 4000 µƐ, and the peak equivalent stress (von Mises) on the abutment screw. All data were analyzed using ANCOVA, followed by Tukey’s post hoc test, with a significance level set at 5% (p < 0.05). It was observed that increased applied force and angulations greater than 45º resulted in higher strain peaks and bone volumes above the physiological threshold, with stress concentration in the distal region of the angled implant necks, a factor that may increase the risk of marginal bone loss. For implants angled at 45º, increasing the length had a limited effect, while implant design showed a greater influence on strain distribution, especially at longer lengths.